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( Marta Perez De Lis Novo ),( Roberto Perez Lvarez ),( Pilar Brito Zeron ),( Antoni Siso Almirall ),( Belchin Kostov ),( Mireia Marti Villalta ),( Albert Bove ),( Hoda Gheitasi ),( Soledad Retamozo ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: To analyze the prevalence of SLE in the field of primary care and to evaluate the management of cardiovascular risk factors (CVRF) in comparison with a non-autoimmune control population. Methods: Analysis of the diagnostic accuracy of SLE by primary care physicians using medical record audit (EMR) in 3 health centers including a population of 44,184 inhabitants. The prevalence of CVRF and clinical cardiovascular disease (CVD) in the SLE population was evaluated and compared with a control population of patients without autoimmune disease matched for gender. Results: 145 patients were identifi ed as SLE. After a case-by-case audit, 112 (77%) patients were confirmed as having SLE, representing a prevalence of 0.25%: 92% were women, with a median follow-up of 11.3 years: death was recorded in 8.9%. The comparison of the main characteristics between SLE and the control group showed that SLE patients had a lower mean age (53.2 vs 60.5, p=0.001), a lower frequency of dyslipidemia (26% vs 47%, p=0.001), a lower mean total cholesterol (199.5 vs 211.3 mg/dL, p=0.023) and a lower mean systolic blood pressure (119 vs. 124.2 mmHg, p=0.043). In contrast, patients with SLE had a higher frequency of renal disease (32.1% vs 12.1, p<0.001), cerebrovascular disease (8.0% vs 1.6%, p=0.027) and non-fatal cardiovascular events (17.0% vs 4.8%, p=0.003). Conclusions: The level of diagnostic accuracy of SLE in our primary care area was high. We found a ‘cardiovascular paradox “: despite having a signifi cantly better degree of control of the main CVRF, and even being a younger population, a higher prevalence of CVD was observed in SLE patients, suggesting that this autoimmune disease is, per se, a cardiovascular risk factor.